Handheld ultrasound assessment of the inferior vena cava and nursing care in an older adult patient with suspected heart failure: a case study

Periodic inferior vena cava assessments can help to detect signs of congestion. This article presents a case involving an 84-year-old patient receiving home care. The aim was to evaluate whether the inferior vena cava diameters had diurnal variation, as well as whether inferior vena cava-based assessment of congestion is useful for nursing care. Using a handheld ultrasound device, the inferior vena cava diameter was measured five times over the course of a day to evaluate diurnal variation. The maximum and minimum inferior vena cava diameters were 2.2–2.3 and 0.9–1.0 cm, respectively, with a respiratory variation rate of 54.5–60.9%. The coefficients of variation were 2.0%, 4.0%, and 4.0%, respectively. The estimated right atrial pressure was 8 mmHg, suggesting slight congestion. No significant diurnal variation was observed. These findings guided nursing care by ensuring more focus on congestion management, including enhanced symptom observation and multidisciplinary collaboration.